Abstract：
:Patients at a low probability of acute cardiac pathology constitute a considerable proportion in many coronary care units (CCUs), such that physicians should consider more effective alternatives than CCU admission "to rule out myocardial infarction." In this article, strategies to increase the efficiency of managing patients with acute chest pain are reviewed. Algorithms aiming to improve the diagnostic accuracy of the general practitioner have been developed but require an electrocardiogram recorded at the home of the patient. Another method of triage encompasses the identification in the emergency room of the hospital of patients at a low probability of acute cardiac pathology by using predictive models that include laboratory assessments. A third strategy includes alternatives to CCUs for patients at a low risk of acute cardiac pathology, such as the creation of a simple observation unit. Finally, some investigators have sought to identify patients with good prognosis for early transfer from the CCU to lower levels of care. It is concluded that a combination of these approaches will be most efficient, and that the most appropriate choice will be determined by local circumstances.
journal_name
Prog Cardiovasc Disjournal_title
Progress in cardiovascular diseasesauthors
Grijseels EW,Deckers JW,Hoes AW,Hartman JA,van der Does E,Simoons MLdoi
10.1016/s0033-0620(05)80021-0subject
Has Abstractpub_date
1995-05-01 00:00:00pages
415-21issue
6eissn
0033-0620issn
1873-1740pii
S0033-0620(05)80021-0journal_volume
37pub_type
杂志文章,评审abstract：:Transcatheter therapy with the MitraClip system (Abbott Structural, Menlo Park, CA) is the most commonly used transcatheter therapy for patients with tricuspid regurgitation, with over 1000 cases performed worldwide. The procedure is an off-label approach that requires meticulous attention to anatomical features obtai...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2019.10.001
更新日期：2019-01-01 00:00:00
abstract：:Tumor necrosis factor alpha (TNF-alpha), a protein belonging to the family of cytokines, is one of the leading mediators of the immune response to inflammation. Its widespread biological effects are modulated by two circulating binding proteins corresponding to the extracellular domain of the membrane receptors, namel...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(98)80028-5
更新日期：1998-07-01 00:00:00
abstract：:Recent clinical studies performed in human subjects have provided important clues that improved our understanding of the mechanisms of atrial fibrillation (AF) and facilitated development of new treatment strategies. When analyzed together, these studies confirm the complexity and multifactorial nature of AF. Because ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2005.06.003
更新日期：2005-07-01 00:00:00
abstract：:The integrated response to severe exercise involves fourfold to fivefold increases in cardiac output, which are due primarily to increases in cardiac rate and to a lesser extent to augmentation of stroke volume. The increase in stroke volume is partly due to an increase in end-diastolic cardiac size (Frank-Starling me...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/0033-0620(76)90018-9
更新日期：1976-09-01 00:00:00
abstract：:The application of ultrasound to clinical evaluation of the symptomatic patient requires less precision and accuracy than when it is used as an instrument to study atherogenesis. The clinician's goal is to locate hemodynamically significant lesions; studies of atherogenesis require auxometry (measurement of the growth...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章
doi：10.1016/0033-0620(84)90007-0
更新日期：1984-01-01 00:00:00
abstract：:The pharmacologic regulation of lipid metabolism in patients with dyslipidemia is unequivocally associated with significant reductions in risk for cardiovascular morbidity and mortality. A number of therapeutic drug classes have been developed in an effort to ever more precisely and intensively modulate lipid metaboli...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2004.04.007
更新日期：2004-09-01 00:00:00
abstract：:Obesity is an independent contributor to cardiovascular disease (CVD) and a major driving force behind racial/ethnic and gender disparities in risk. Due to a multitude of interrelating factors (i.e., personal, social, cultural, economic and environmental), African-American (AA) women are disproportionately obese and t...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2016.02.003
更新日期：2016-05-01 00:00:00
abstract：:Beta blockers have long been used in patients who have experienced a myocardial infarction. However, many new therapies are available for this patient group, and as a result, the current role of beta blockers may have become uncertain. In this article we address a series of questions related to the important and conti...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2002.31586
更新日期：2002-01-01 00:00:00
abstract：:Trastuzumab is the standard of care for the treatment of patients with ERB2-positive breast cancer. In a minority of patients, trastuzumab is associated with an increased incidence of cardiac dysfunction that ranges from asymptomatic decreases in left ventricular ejection fraction to symptomatic heart failure. In tria...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2010.07.001
更新日期：2010-09-01 00:00:00
abstract：:The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2018.11.005
更新日期：2018-01-01 00:00:00
abstract：:The success of modern therapies in congenital heart disease has produced a large and growing population of adults with congenital heart disease as a chronic condition. Such success increasingly raises a host of ethical issues, from resource utilization to end of life decision-making. The importance of a multidisciplin...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2012.10.004
更新日期：2012-11-01 00:00:00
abstract：:Two central concepts of human hypertensive disease remain poorly understood: (1) elevated blood pressure as merely one component of an underlying systemic condition, characterized by multiple defects in diverse tissues (eg, "Syndrome X"), and (2) the heterogeneity of hypertension, in which different and even opposite ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(99)70006-x
更新日期：1999-07-01 00:00:00
abstract：:In heart failure (HF) management, noninvasive quantification of left ventricular (LV) function is rapidly evolving. Deformation parameters, such as strain, continue to challenge the central role of ejection fraction (EF) in diagnosis and prognostication of LV dysfunction in HF. The increasing recognition and use of de...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2020.05.007
更新日期：2020-01-01 00:00:00
abstract：:Historically, risk stratification for survivors of acute myocardial infarction (AMI) has centered on 3 principles: assessment of left ventricular function, detection of residual myocardial ischemia, and estimation of the risk for sudden cardiac death. Although these factors still have important prognostic implications...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2000.0420273
更新日期：2000-01-01 00:00:00
abstract：:In recent years, a number of peptide and nonpeptide signalling autacoids have been implicated in the regulation of cardiac myocyte growth as well as vasculogenesis and angiogenesis, and in the function of cardiac muscle following development. In this review, we first examine the evidence for a role for specific cytoki...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(97)80033-3
更新日期：1997-01-01 00:00:00
abstract：:Stents or endoprostheses have evolved since their introduction. Initially used only in the vascular system, the use of stents has expanded to use in the biliary, urinary, and gastrointestinal tracts and in the tracheo-bronchial tree. Current use of stents includes treatment of both benign and malignant conditions, wit...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(96)80025-9
更新日期：1996-09-01 00:00:00
abstract：:There has been a lot of progress in measurement techniques of the pulmonary circulation in recent years, and this has required updating of basic physiological knowledge. Pulmonary artery pressures (PAP) are normally low and dependent on left atrial pressure (LAP) and cardiac output (CO). Therefore, defining the functi...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2014.12.003
更新日期：2015-03-01 00:00:00
abstract：:A large number of drug trials for prevention of restenosis have been conducted with many showing little or conflicting benefit. Antiplatelets such as aspirin, ticlopidine and thromboxane A2 receptor inhibitors have not shown a clear benefit. Similarly, antithrombotics, either acting indirectly such as heparin, or as d...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(97)80006-0
更新日期：1997-09-01 00:00:00
abstract：:Tricuspid regurgitation (TR) remains a complex valve pathology affecting nearly two million people in the United States. Although it can present as a primary valve pathology, TR often presents as a late finding in patients with severe pulmonary disease or end-stage chronic heart failure. Surgical repair of isolated TR...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2019.11.016
更新日期：2019-01-01 00:00:00
abstract：:Hypertension (HTN) is the most common chronic disease in the U.S., and the standard model of office-based care delivery has yielded suboptimal outcomes, with approximately 50% of affected patients not achieving blood pressure (BP) control. Poor population-level BP control has been primarily attributed to therapeutic i...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2016.09.005
更新日期：2016-01-01 00:00:00
abstract：:Obesity, particularly severe obesity is capable of producing hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function. These include increased cardiac output, left ventricular hypertrophy and diastolic and systolic dysfunction of both ventricles. Facilitated by co-morbidities s...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.09.003
更新日期：2014-01-01 00:00:00
abstract：:Heparin has been the principal anticoagulant in the management of ST-elevation myocardial infarction (STEMI) but has several limitations. Although glycoprotein IIb/IIIa inhibitors have been major adjuncts in previous years, in the era of novel P2Y12 receptor inhibitors they may have a greater role in bailout. Low mole...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2015.08.007
更新日期：2015-11-01 00:00:00
abstract：:It is being increasingly appreciated that a substantial number of patients with congestive heart failure (CHF) have relatively preserved systolic function. Although these individuals appear to have a somewhat better prognosis than those with low ejection fractions, they experience significant symptoms and frequently r...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(98)80053-4
更新日期：1998-01-01 00:00:00
abstract：:Because not all laboratories use the monitoring and stimulation protocols used in the Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, we reanalyzed the ESVEM patients' data using alternative, commonly used Holter monitor (HM) and programmed stimulation efficacy criteria to determine if d...
journal_title：Progress in cardiovascular diseases
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0033-0620(96)80029-6
更新日期：1996-03-01 00:00:00
abstract：:Physicians who supervise stress-imaging procedures, whether they be stress nuclear or stress echocardiography tests, are increasingly required to incorporate important principles in the interpretation of the test results. Important guiding principles, common to these tests, are reviewed in this article. The principles...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章
doi：10.1053/pcad.2001.20501
更新日期：2001-01-01 00:00:00
abstract：:Patients with symptomatic carotid artery disease should be managed by a multidisciplinary team including neurologists, vascular surgeons and interventionalists. Duplex ultrasound is the most widely used diagnostic modality to assess carotid disease, followed by additional imaging tests (CT- or MR-angiography) to confi...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2017.04.002
更新日期：2017-01-01 00:00:00
abstract：:Microbubbles are an excellent intravascular tracer, and both the rate of myocardial opacification (analogous to coronary microvascular perfusion) and contrast intensity (analogous to myocardial blood volume) provide unique insights into myocardial perfusion. A strong evidence base has been accumulated to show comparab...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2015.03.005
更新日期：2015-05-01 00:00:00
abstract：:Stem cells are potential agents for the treatment of myocardial infarcts among other heart diseases. Over the past decade, the scientific community has extensively used a wide variety of cells and examined their capacity to both regenerate the infarcted myocardium and improve functionally the diseased hearts. Some of ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2007.02.006
更新日期：2007-05-01 00:00:00
abstract：:Acute myocardial infarction is caused by coronary occlusion, and the mainstay of treatment has become reperfusion by either coronary angioplasty with possible stenting or surgical bypass grafting. Unfortunately, reperfusion can seldom be done soon enough to prevent infarction. Thus, the search for effective cardioprot...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2006.02.005
更新日期：2006-03-01 00:00:00
abstract：:Key questions concerning strategies for diagnosis, prevention, and treatment of heart disease in women remain unanswered. Thrombolytic therapy has been shown to reduce mortality similarly in men and women. In addition, percutaneous coronary intervention for acute coronary syndromes is as effective in women as in men. ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2010.07.004
更新日期：2010-11-01 00:00:00
